Imagine if the room started spinning every time you moved your head. For people with vestibular problems, this is a reality. But there is good news: vestibular rehabilitation therapy can help!
This type of physiotherapy helps to retrain the brain and restore balance. It can be life-changing for people who suffer from vertigo, dizziness, and other vestibular problems.
What is the vestibular system?
When you get out of bed or walk over rough terrain, a link between your inner ear and your brain helps you maintain your balance. This is referred to as your vestibular system.
Information from your inner ear organs is processed by your brain. Furthermore, it receives information from other senses such as vision, joints, muscles, and tendons throughout your body, hearing, touch, and even functions such as memory and emotion.
These nerve impulses are then sent to muscles in your eyes, trunk, and limbs, allowing you to respond appropriately to each situation.
What causes vestibular problems?
Head injury, ageing, and viral infection are the most common causes of vestibular dysfunction. Other diseases, as well as genetic and environmental factors, can cause or contribute to vestibular disorders.
Types of vestibular disorders
- Benign Paroxysmal Positional Vertigo (BPPV)
- Cervicogenic Dizziness
- Vestibular Neuritis/Labyrinthitis
- Unilateral Vestibular Hypofunction (UVH)
- Mal de Debarquement (MdDS)
- Vestibular Migraine
- Post Concussion Syndrome (PCS)
- Meniere’s Disease
- Neurological conditions (i.e. stroke, traumatic brain injury)
- Vestibular deconditioning from ageing or inactivity
- Persistent Postural Perceptual Dizziness (PPPD)
Common vestibular symptoms
- Problems with vision, double vision, shaky vision with head movement, difficulty focusing, and poor tolerance to screens.
- Vertigo, a sense of spinning.
- Imbalance and walking difficulties.
- Nausea, vomiting, and exhaustion.
- Tightness, stiffness, and pain in the neck.
- Headaches.
- Dizziness or lightheadedness in general.
- Falls that occur frequently.
What is the most common vestibular disorder?
Benign Paroxysmal Positional Vertigo (BPPV) is the most common vestibular disorder. BPPV causes short, intense bouts of dizziness or vertigo associated with quick head movements, rolling over in bed, or getting up in the morning. Most people report acute episodes of nausea during or shortly after these dizziness attacks.
BPPV occurs when tiny calcium carbonate crystals (otoconia) become dislodged and travel around the canals of the middle ear. These crystals stimulate the nerves that detect head rotation. The brain receives the message that the head is spinning even when the head has only moved position slightly.
BPPV can come and go for no apparent reason. It is more common in ageing as there is degeneration of the vestibular system in the inner ear. 70% of people over 70 suffer from the condition at least once in their lifetime. Other causes include post head injury and during bouts of colds/flu.
The diagnosis of BPPV is based on:
- Your medical history
- Dizziness symptoms
- Results of balance assessment
- Physical examination
What is vestibular rehabilitation therapy?
Vestibular rehabilitation therapy (VRT) is a type of physiotherapy used to treat and improve the symptoms of vestibular disorders. It frequently entails manual head movements and a progressive programme of exercises to reduce vertigo and dizziness, imbalance, visual issues and falls.
When the vestibular system is injured, the central nervous system can compensate for the decreased function of the inner ears. To maintain vestibular balance, the brain adapts to the imbalanced signals from the vestibular system by learning to rely more heavily on alternative signals from other systems in the body.
When this brain compensation occurs, the patient’s symptoms are relieved, allowing them to resume normal function.
Benefits from vestibular rehabilitation therapy
- Improve your focus or concentration, as well as your memory.
- Improved ability to stabilise gaze or vision and track or focus on near and far objects.
- Dizziness symptoms have been reduced.
- Reduced risk of falling.
- Less nausea or vomiting.
- Balance is improved when standing or sitting.
How long does vestibular rehabilitation take to work?
Vestibular rehabilitation therapy generally takes six to eight weeks, with one or two sessions per week. On the other hand, some patients can successfully address their balance or dizziness issues in just one or two therapy sessions and experience results in as little as 48 hours.
However, this depends on the patient’s diagnosis, the severity of their symptoms, and their response to therapy.
The effectiveness of the exercise programme is determined not only by the exercises selected by the physiotherapist but also by the patient’s compliance with the program. Inconsistent performance of the prescribed exercises is the most common cause of a delay in recovery.
Variables that affect vestibular rehabilitation
- The stage at which treatment is initiated.
- Medication.
- Psychogenic Factors.
- Symptom severity.
- Visual and somatosensory inputs.
- Duration of daily exercise.
- The age of the patient.
Final thoughts
Vestibular rehabilitation is an exercise-based program designed by a vestibular physiotherapist to improve balance and reduce dizziness-related problems.
The length of time it takes to recover from a vestibular disorder is highly variable and can range from a couple of visits to a chronic condition that is managed over time.
